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The aerodynamic modelling is one of the challenging tasks that is generally established using the results of the computational fluid dynamic software and wind tunnel analysis performed either on the scaled model or the prototype. In order to improve the confidence of the estimates, the conventional parameter estimation methods such as equation error method (EEM) and output error method (OEM) are more often applied to extract the aircraft’s stability and control derivatives from its respective flight test data. The quality of the estimates gets influenced due to the presence of the measurement and process noises in the flight test data. With the advancement in the machine learning algorithms, the data driven methods have got more attention in the modelling of a system based on the input-output measurements and also, in the identification of the system/model parameters. The research article investigates the longitudinal stability and control derivatives of the aerodynamic models by using an integrated optimisation algorithm based on a recurrent neural network. The flight test data of Hansa-3 and HFB 320 aircraft were used as case studies to see the efficacy of the parameter estimation algorithm and further, the confidence of the estimates were demonstrated in terms of the standard deviations. Finally, the simulated variables obtained using the estimates demonstrate a qualitative estimation in the presence of the noise.
Cell-mediated immunity plays an important role in host defence against fungal pathogens, regulated by differentiation of lymphocytes towards T-helper 1 or 2 cells. This study reports intracellular cytokine variation in terms of invasive fungal sinusitis type and outcome.
Methods
The mononuclear leukocytes of 15 patients with invasive fungal sinusitis (mucormycosis in 8, aspergillus in 7) were stained with antibodies against intracellular cytokines, after fungal antigen stimulation and culture, and immunophenotyped. Patients were followed up for six months, with clinical course categorised as improvement, worsening or death.
Results
The mean percentages of mononuclear cells producing interleukins 4, 5, 10 and 12, and interferon-γ, in the mucormycosis group were 0.575, 0.284, 8.661, 4.460 and 1.134, respectively, while percentages in the aspergillosis group were 0.233, 0.492, 4.196, 4.466 and 1.533. Cells producing interleukin 4 and 10 were higher in the mucormycosis group, while those producing interleukin-12 and interferon-γ were lower. Cells producing interleukins 4 and 12 were higher in patients with a poor outcome (p-values of 0.0662 and 0.0373, respectively), while those producing interferon-γ were lower (p = 0.0864).
Conclusion
Adaptive cell-mediated immunity is expressed differently in two categories of invasive fungal sinusitis, and the cytokine expression pattern is related to prognosis.
To elucidate the aetiopathogenesis of facial neuritis in coronavirus disease 2019 associated mucormycosis.
Methods
A retrospective review was conducted of coronavirus disease 2019 associated mucormycosis patients who presented with peripheral facial nerve palsy from January 2021 to July 2021. The clinico-radiological details of four patients were assessed to examine the potential mechanism of facial nerve involvement.
Results
Serial radiological evaluation with contrast-enhanced computed tomography and contrast-enhanced magnetic resonance imaging revealed infratemporal fossa involvement in all cases, with the inflammation extending along fascial planes to reach the stylomastoid foramen. Ascending neuritis with an enhancement of the facial nerve was demonstrated in all cases.
Conclusion
The likely explanation for facial palsy in patients with coronavirus disease 2019 associated mucormycosis, backed by radiology, is the disease abutting the facial nerve at the stylomastoid foramen and causing ascending neuritis of the facial nerve.
The flag leaf acts as a functional leaf in rice, Oryza sativa L., primarily supplying photosynthate to the developing grains and influencing yields to a certain extent. Drought stress damages the leaf physiology, severely affecting grain fertility. Autumn rice of northeast India is called locally as ‘ahu’ rice, and is known for its drought tolerance. Exploring diverse germplasm resources at the morphological level using an association mapping approach can aid in identifying the genomic regions influencing leaf shape dynamics. A marker–trait association (MTA) study was carried out using 95 polymorphic SSR markers and a panel of 273 ahu rice germplasm accessions in drought stress and irrigated conditions. The trials suggest that at the vegetative stage, drought stress significantly affects leaf morphology. The leaf physiology of some tolerant accessions was relatively little affected by stress and these can be considered as ideal varieties for drought conditions. The phenotypic coefficient of variance and genotypic coefficient of variance values implied moderate to high variability for the leaf traits studied. Analysis of molecular variance inferred that 11% of variation in the germplasm panel was due to differences between populations, while the remaining 89% may be attributed to a difference within subgroups formed through STRUCTURE analysis. Using the mixed linear model approach revealed 11 MTAs explaining between 4.5 and 20.0% of phenotypic variance at P > 0.001 for all the leaf traits. The study concludes that ahu rice germplasm is extremely diverse and can serve as a valuable resource for mining desirable alleles for drought tolerance.
In spite of continuous refinements in tympanoplasty techniques, results are variable, and it is not uncommon to see a discharging eardrum even after a good graft uptake. This study aimed to evaluate the efficacy of total annulus excision tympanoplasty in comparison with conventional underlay tympanoplasty.
Method
This was a double blinded, randomised, controlled trial performed at a tertiary care centre. After inclusion and exclusion criteria were met, 56 patients were enrolled and randomised, and 28 patients were allocated to each group (group A (conventional tympanoplasty) and group B (total annulus excision)). Patients and evaluators were blind to the procedure performed.
Results
Patients in group B (total annulus excision) showed better graft uptake and no discharge with better gains in air conduction thresholds (p < 0.05) when compared with group A (conventional tympanoplasty).
Conclusion
In view of the advantages it offers, total annulus excision tympanoplasty may be preferred over the conventional techniques in patients with central perforations.
This study aimed to evaluate serum otolin-1 levels in patients with benign paroxysmal positional vertigo and to compare these levels with healthy individuals.
Method
This was a case-control study. After obtaining institutional ethical committee clearance, the serum level of otolin-1 was calculated in adult individuals (18–75 years old) who were divided into group 1 (patients presenting with benign paroxysmal positional vertigo) and group 2 (healthy patients without benign paroxysmal positional vertigo as the control group). Data analysis was carried out to compare the serum levels in the cases and controls. A p-value less than 0.05 was considered significant.
Results
A total of 70 age-matched individuals (cases, n = 40; controls, n = 30) were included in the study. The mean serum level of otolin-1 was 636.8 pg/ml (range, 259–981 pg/ml) in the group of patients with benign paroxysmal positional vertigo and 236.2 pg/ml (range, 189–370 pg/ml) in the control group. The difference was statistically significant (p = 0.0000).
Conclusion
The serum levels of otolin-1 in patients with benign paroxysmal positional vertigo are significantly higher compared with individuals without benign paroxysmal positional vertigo.
Sexed semen is one of the newest reproductive technologies available for dairy farmers and can fulfil their desire to produce a high percentage of female calves. The present study was designed to define the willingness of Indian dairy farmers to pay for sexed semen. Hence, 120 small holder dairy farmers and 90 commercial dairy farmers were randomly selected from Karnal and Yamunanagar districts in North-western Haryana, where there is a high proportion of crossbred dairy cattle. Willingness to pay for sexed semen was evaluated by a contingent valuation method and its determinants by an interval regression model. The majority of the small holder dairy farmers (81.67%) were willing to pay for sexed semen and they were ready to pay around INR 340 per sexed semen straw. Almost all (99%) of the commercial dairy farmers were willing to pay around INR 770 per sexed semen straw, i.e. more than double the value identified by small holder dairy farmers. Among all the predictors fitted in the interval regression model to explain the willingness to pay for sexed semen by the commercial dairy farmers, namely education level, herd size and attitude towards public extension systems, were positive and significant contributors. Our findings may help to identify what subsidy is required to promote sexed semen among dairy farmers, and as a consequence further improve breeding policies by introducing this new livestock production technology with the active participation of the dairy farmers.
Understanding the clinical risk factors for COVID-19 disease severity and outcomes requires a combination of data from electronic health records and patient reports. To facilitate the collection of patient-reported data, as well as accelerate and standardize the collection of data about host factors, we have constructed a COVID-19 survey. This survey is freely available to the scientific community to send electronically for patients to complete online. This patient survey is designed to be comprehensive, yet not overly burdensome, to gather data useful for a range of clinical investigations, and to accommodate a wide variety of implementation settings including at a COVID-19 testing site, at home during infection or after recovery, and/or for individuals while they are hospitalized. A widely adopted standardized survey that can be implemented online with minimal resources can serve as a critical tool for combining and comparing data across studies to improve our understanding of COVID-19 disease.
Background: Increasing Emergency Department (ED) stretcher occupancy with admitted patients at our tertiary care hospital has contributed to long Physician Initial Assessment (PIA) times. As of Oct 2019, median PIA was 2.3 hours and 90th percentile PIA was 5.3 hours, with a consequent 71/74 PIA ranking compared to all Ontario EDs. Ambulatory zone (AZ) models are more commonly used in community EDs compared to tertiary level EDs. An interdisciplinary team trialled an AZ model for five days in our ED to improve PIA times. Aim Statement: We sought to decrease the median PIA for patients in our ED during the AZ trial period as compared to days with similar occupancy and volume. Measures & Design: The AZ was reserved for patients who could walk from a chair to stretcher. In this zone, ED rooms with stretchers were for patient assessment only; when waiting for results or receiving treatment, patients were moved into chairs. We removed nursing assignment ratios to increase patient flow. Our outcome measure was the median PIA for all patients in our ED. Our balancing measure was the 90th percentile PIA, which could increase if we negatively impacted patients who require stretchers. The median and 90th percentile PIA during the AZ trial were compared to similar occupancy and volume days without the AZ. Additional measures included ED Length of Stay (LOS) for non-admitted patients, and patients who leave without being seen (LWBS). Clinicians and patients provided qualitative feedback through surveys. Evaluation/Results: The median PIA during the AZ trial was 1.5 hours, compared to 2.1 hours during control days. Our balancing measure, the 90th percentile PIA was 3.7 hours, compared to 5.0 during control days. A run chart revealed both median and 90th percentile PIA during the trial were at their lowest points over the past 18 months. The number of LWBS patients decreased during the trial; EDLOS did not change. The majority of patients, nurses, and physicians felt the trial could be implemented permanently. Discussion/Impact: Although our highly specialized tertiary care hospital faces unique challenges and high occupancy pressures, a community-hospital style AZ model was successful in improving PIA. Shorter PIA times can improve other quality metrics, such as timeliness of analgesia and antibiotics. We are working to optimize the model based on feedback before we cycle another trial. Our findings suggest that other tertiary care EDs should consider similar AZ models.
Before October 2012 there was no service level agreement for psychiatry cover in Whiston Hospital, an acute trust in the UK. The Crisis team would visit on goodwill to assess patients. This changed when a Liaison Psychiatry (LP) service was commissioned to provide 24 hour cover, Monday to Sunday for the Emergency Department (ED) for adults.
Aims:
To quantify waiting times to be assessed by psychiatry, comparing the new LP Service (intervention group) to its predecessor (control). The null hypothesis being that the waiting time for the control and intervention group are the same.
Methods:
The authors prospectively collected data on all referrals received by the LP service in the first three months of operation n=305 and retrospectively collected data on a random sample of 50 patients referred from ED in the same months 2011 (control).
Results:
The median time from referral to the time of psychiatric assessment in the control group was 162.5 minutes [IQR 130–330], the mean time was 246.16 [95% CI 180 to 312]. The median time from referral to the time of psychiatric assessment following the introduction of the LP service was 30 minutes [IQR 15-90], the mean time was 79.63 [95% CI 65 to 93]. When the two samples were compared using an independent t test they were significantly different p<0.002.
Conclusions:
The new LP service has decreased the median wait for a psychiatry assessment by 132 minutes. The team currently seeS 82% of referrals within 60 minutes. This improves patient safety and encourages appropriate and timely discharge.
Mental health stigma is a multidimensional concept that encompasses many different themes and definitions. Public stigma is defined as the degree to which the general public holds negative views and discriminates against a specific group.
Objective
To understand the context and correlates of stigma in multi-ethnic Singapore.
Aims
The current study aimed to (i) explore the factor structure of the Depression Stigma Scale and the Social Distance Scale using an exploratory structural equation modelling approach and (ii) examine the correlates of the identified dimensions of stigma in the general population of Singapore.
Methods
Data for the current study came from a larger nation-wide cross-sectional study of mental health literacy conducted in Singapore. All respondents were administered the Personal and Perceived scales of the Depression Stigma Scale and the Social Distance scale to measure personal stigma and social distance respectively.
Results
The findings from the factor analysis revealed that personal stigma formed two distinct dimensions comprising “Weak-not-Sick” and “Dangerous/Unpredictable” components while social distance stigma items loaded strongly into a single factor. Those of Malay and Indian ethnicity, lower education, lower income status and those who were administered the depression and alcohol abuse vignette were significantly associated with higher weak-not-sick scores. Those of Indian ethnicity, 6 years of education and below, lower income status and those who were administered the alcohol abuse vignette were significantly associated with higher dangerous/unpredictable scores.
Conclusion
There is a need for well-planned and culturally relevant anti-stigma campaigns in this population.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
To assess the role of white-tailed deer (Odocoileus virginianus, WTD) in the epidemiology of toxoplasmosis, we conducted a national survey of WTD across the USA for Toxoplasma gondii infection. To do this, we combined serology with parasite isolation to evaluate the prevalence and genetic diversity of T. gondii in this game species. From October 2012 to March 2019, serum and tissues were collected from 914 WTD across the USA. Serum samples were screened for antibodies to T. gondii, and then the tissues of seropositive WTD were bioassayed in mice. Antibodies were detected in 329 (36%) of 914 WTD tested by the modified agglutination test (positive reaction at 1:25 or higher). Viable T. gondii was isolated from the heart of 36 WTD from 11 states. Three of the 36 isolates were pathogenic but not highly virulent to outbred Swiss Webster mice and all 36 isolates could be propagated further in cell culture and were genotyped. For genotyping, DNA extracted from cell culture-derived tachyzoites was characterized by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) using the genetic markers SAG1, SAG2, SAG3, BTUB, GRA6, c22-8, c29-2, L358, PK1 and Apico. Genotyping revealed seven ToxoDB PCR-RFLP genotypes, including 24 isolates for genotype #5 (haplogroup 12), four isolates for #2 (type III, haplogroup 3), three isolates for genotypes #1 (type II, haplogroup 2), two isolates for genotypes #3 (type II, haplogroup 2) and one isolate each for #39, #221 and #224. Genotype #5 was the most frequently isolated, accounting for 66.6% (24 of 36) of the isolates. Combining the 36 isolates from this study with previously reported 69 isolates from WTD, 15 genotypes have been identified. Among these, 50.4% (53/105) isolates belong to genotype #5. Our results indicate moderate genetic diversity of T. gondii in WTD. The results also indicate that undercooked venison should not be consumed by humans or fed to cats.
Data-driven materials design informed by legacy data-sets can enable the education of a new workforce, promote openness of the scientific process in the community, and advance our physical understanding of complex material systems. The performance of structural materials, which are controlled by competing factors of composition, grain size, particle size/distribution, residual strain, cannot be modelled with single-mechanism physics. The design of optimal processing route must account for the coupled nature of the creation of such factors, and requires students to learn machine learning and statistical modelling principles not taught in the conventional undergraduate or graduate level Materials Science and Engineering curricula. Therefore, modified curricula with opportunities for experiential learning are paramount for workforce development. Projects with real-world data provide an opportunity for students to establish fluency in the iterative steps needed to solve relevant scientific and engineering process design questions.
Neonatal aortic thrombosis is a rare occurrence but can be life-threatening. Most aortic thrombosis in neonates is related to umbilical artery catheters. A case of a neonate with a spontaneous aortic thrombosis is described here along with a comprehensive review of the literature for cases of neonatal aortic thrombosis not related to any intravascular device or procedure. The aetiologies of these spontaneous thromboses and the relevance of hypercoagulable disorders are discussed. The cases were analysed for odds of death by treatment method adjusted for era. The reference treatment method was thrombolysis and anticoagulation. No other treatment modality had significantly lower odds than the reference. Surgery alone had higher odds for death than the reference, but this may be confounded by severity of case. The management recommendations for clinicians encountering neonates with spontaneous neonatal aortic thrombosis are discussed.
While the burden of dementia is increasing in low- and middle-income countries, there is a low rate of diagnosis and paucity of research in these regions. A major challenge to study dementia is the limited availability of standardised diagnostic tools for use in populations with linguistic and educational diversity. The objectives of the study were to develop a standardised and comprehensive neurocognitive test battery to diagnose dementia and mild cognitive impairment (MCI) due to varied etiologies, across different languages and educational levels in India, to facilitate research efforts in diverse settings.
Methods:
A multidisciplinary expert group formed by Indian Council of Medical Research (ICMR) collaborated towards adapting and validating a neurocognitive test battery, that is, the ICMR Neurocognitive Tool Box (ICMR-NCTB) in five Indian languages (Hindi, Bengali, Telugu, Kannada, and Malayalam), for illiterates and literates, to standardise diagnosis of dementia and MCI in India.
Results:
Following a review of existing international and national efforts at standardising dementia diagnosis, the ICMR-NCTB was developed and adapted to the Indian setting of sociolinguistic diversity. The battery consisted of tests of cognition, behaviour, and functional activities. A uniform protocol for diagnosis of normal cognition, MCI, and dementia due to neurodegenerative diseases and stroke was followed in six centres. A systematic plan for validating the ICMR-NCTB and establishing cut-off values in a diverse multicentric cohort was developed.
Conclusions:
A key outcome was the development of a comprehensive diagnostic tool for diagnosis of dementia and MCI due to varied etiologies, in the diverse socio-demographic setting of India.
Feral swine are known reservoirs of various pathogens, including Toxoplasma gondii. Here, we report the first national survey of viable T. gondii in feral swine in the USA. We paired serological surveys with parasite isolation and bioassay to evaluate the prevalence and genetic diversity of these parasites. From 2012–2017, sera and tissues from 1517 feral swine across the USA were collected for the isolation of viable T. gondii. Serum samples were initially screened for antibodies to T. gondii, and then the tissues of seropositive feral swine were bioassayed in mice. Antibodies were detected in 27.7% of feral swine tested by the modified agglutination test (1:25 or higher). Antibody positive rates increased significantly with age, with 10.1% of juveniles, 16.0% of sub-adults and 38.4% of adults testing seropositive. Myocardium (50 g) from 232 seropositive feral swine was digested in pepsin and bioassayed in mice. Viable T. gondii was isolated from 78 feral swine from 21 states. Twelve of the 78 isolates were pathogenic to outbred Swiss Webster mice and 76 of the 78 isolates could be propagated further in cell culture and were genotyped. For genotyping, deoxyribonucleic acid extracted from cell culture-derived tachyzoites was characterized by polymerase chain reaction restriction fragment length polymorphism using the genetic markers SAG1, SAG2, SAG3, BTUB, GRA6, c22-8, c29-2, L358, PK1 and Apico. Genotyping revealed 15 ToxoDB genotypes, including 43 isolates for genotype #5 (haplogroup 12), 11 isolates for #24, four isolates for #2 (haplogroup 3), two isolates for each of genotypes #3 (haplogroup 2), #4 (haplogroup 12), #216, #221, #289 and #297 and one isolate for each of genotypes #1 (haplogroup 2), #39, #66, #260, #261 and #299. Genotype #5 was the most frequently isolated, accounted for 57% (43/76) of the isolates, followed by #24, accounted for 14% (11/76). Genotypes #260, #289, #297 and #299 are new types. Genotype #289 was highly virulent to mice and originated from feral swine collected in Louisiana on the same day at the same location. Genotype #216 was previously demonstrated to be highly virulent to mice. Our results indicate moderate genetic diversity of T. gondii in feral swine in the USA, with the genotype #5 (haplogroup 12) dominant in the continental USA, whereas genotype #24 (10/14) was dominant in Hawaii, suggesting different population structures of the parasites among the two distinct geographical locations.
The research paper addresses the problem of estimating aerodynamic parameters using a Gauss-Newton-based optimisation method. The process of the optimisation method lies on the principle of minimising the residual error between the measured and simulated responses of the system. Usually, the simulated response is obtained by integrating the dynamic equations of the system, which is found to be susceptible to the initial values, and the integration method. With the advent of the feedforward neural network, the data-driven regression methods have been widely used for identification of the system. Among them, a variant of feedforward neural network, extreme learning machine, which has proven the performance in terms of computational cost, generalisation, and so forth, has been addressed to predict the responses in the present study. The real flight data of longitudinal and lateral-directional motion have been considered to estimate their respective aerodynamic parameters. Furthermore, the estimates have been validated with the values of the classical estimation methods, such as the equation-error and filter-error methods. The sample standard deviations of the estimates demonstrate the effectiveness of the proposed method. Lastly, the proof-of-match exercise has been conducted with the other set of flight data to validate the estimated parameters.
According to the celebrated Bolgiano–Obukhov (Bolgiano, J. Geophys. Res., vol. 64 (12), 1959, pp. 2226–2229; Obukhov, Dokl. Akad. Nauk SSSR, vol. 125, 1959, p. 1246) phenomenology for moderately stably stratified turbulence, the energy spectrum in the inertial range shows a dual scaling: the kinetic energy follows (i) ${\sim}k^{-11/5}$ for $k<k_{B}$, and (ii) ${\sim}k^{-5/3}$ for $k>k_{B}$, where $k_{B}$ is the Bolgiano wavenumber. The $k^{-5/3}$ scaling, akin to passive scalar turbulence, is a direct consequence of the assumption that buoyancy is insignificant for $k>k_{B}$. We revisit this assumption, and using the constancy of kinetic and potential energy fluxes and simple theoretical analysis, we find that the $k^{-5/3}$ spectrum is absent. This is because the velocity field at small scales is too weak to establish a constant kinetic energy flux as in passive scalar turbulence. A quantitative condition for the existence of the second regime is also derived in the paper.
Let (R, ) be an analytically unramified local ring of positive prime characteristic p. For an ideal I, let I* denote its tight closure. We introduce the tight Hilbert function $$H_I^*\left( n \right) = \Im \left( {R/\left( {{I^n}} \right)*} \right)$$ and the corresponding tight Hilbert polynomial $$P_I^*\left( n \right)$$, where I is an m-primary ideal. It is proved that F-rationality can be detected by the vanishing of the first coefficient of $$P_I^*\left( n \right)$$. We find the tight Hilbert polynomial of certain parameter ideals in hypersurface rings and Stanley-Reisner rings of simplicial complexes.